1. The University of Sydney Sydney School of Public Health Qualitative Health Research Collaboration (QHeRC) 23 rd Feb 2010 Sian Smith Research Fellow, Screening and Test Evaluation Program Sydney School of Public Health, USYD Quality in qualitative health research

2. The University of Sydney Sydney School of Public Health 9.00 – 9.20 Background to session 9.20 – 9.40 Overview of five articles 9.40 – 10.20 Small group discussion 10.20 – 11.00 Report back 11.00 – 12.00 Morning tea & general discussion Summary

3. The University of Sydney Sydney School of Public Health Aims of this session To review how different researchers reflect on and write about issues of quality in qualitative research; To discuss the advantages and disadvantages of different approaches to assessing quality; To share stories and experiences of applying criteria to appraise or improve the quality of research.

4. The University of Sydney Sydney School of Public Health Article 1

5. The University of Sydney Sydney School of Public Health Are researchers using qualitative research to its full potential? Qualitative research can be too deductive. ‘One-shot’ interviews with little explanation. Interviews with health professionals – ‘getting behind the facade.’ Ethnography- seeing what people do. Mixed methods research – comprehensive picture of research enquiry. Value of qualitative synthesis- drawing existing studies together and generating new ‘higher order’ concepts. Pope & Mays, 2009 BMJ; 339:737-739

6. The University of Sydney Sydney School of Public Health Article 2 NSW Pub Health Bull 2009, 20 (7-8): 105-111

7. The University of Sydney Sydney School of Public Health Basic principles for conducting qualitative enquiry: Understand social world – complex, dynamic, ordinary. Theory is ubiquitous - building theory to explain social phenomenon, and informed by theory in creating and reporting data. Participants are ‘special’ and ‘uniquely positioned’, identify samples in a flexible and dynamic way. Analysis means more than stating ‘X themes emerged’, thorough account of analytic methods. Distinguish between methods (what you do) and methodology (why you do it), less written about methodology in articles. More justification at each stage of research. Carter et al. NSW Pub Health Bull 2009, 20 (7-8): 105-111 Carter et al. Qual Health Res 2007: 17 (10): 1316-28 What do we mean by good qualitative research?

8. The University of Sydney Sydney School of Public Health Article 3

9. The University of Sydney Sydney School of Public Health Appraising qualitative studies using quantitative criteria is not appropriate. Within qualitative research, numerous approaches, paradigms, schools, which vary in ontological, epistemological and methodological positions. Comprehensive framework for making decisions about quality. Two core principles:  Transparency –clear and detailed information about every step of the research process  Systematicity –description of regular or standard qualitative data collection and analysis methods Establishing rigour in qualitative research Meyrick 2006, J Hlth Psych 11 (5),799-808

10. The University of Sydney Sydney School of Public Health Meyrick 2006, J Hlth Psych 11 (5),799-808

11. The University of Sydney Sydney School of Public Health Article 4

12. The University of Sydney Sydney School of Public Health Sensitivity to context  Theoretical; previous empirical work; theory building ‘vertical generalisation’; social context; ethical and power (im)balance issues Commitment and rigour  Engagement in topic, methodological competence and skill, thorough data collection and analysis Transparency and coherence  Disclosure of research process (data collection, analysis), fit between theory and method, reflexivity (motivations, constraints) Impact and importance  Theoretical, socio-cultural, practical Features of good qualitative research Yardley, L. Psychology & Health 2000; 15: 215-228

13. The University of Sydney Sydney School of Public Health Article 5

14. The University of Sydney Sydney School of Public Health Kitto et al. MJA 2008; 188: 243- 246 MJA guidelines for enhancing rigour in qualitative research When writing for MJA recommend that authors focus on a few aspects of findings and use visual displays strategically. Suggest word limit for each section

15. The University of Sydney Sydney School of Public Health Patterns across articles Concepts of quality used to assess qualitative research should be quite different from those used to assess quantitative research Move away from ‘checklists’ to frameworks and guidelines Propose criteria that can be applied to all qualitative research – a ‘pluralistic approach’

16. The University of Sydney Sydney School of Public Health Questions for discussion How necessary are defined criteria for quality of qualitative research? Can one set of criteria work for all qualitative research? Which of the options do you prefer? Why? Are there any that you violently disagree with? What is thematic analysis exactly? Is thematic analysis enough? Is it too deductive? How feasible is the MJA format and word limit? Do word limits affect the quality of qualitative research? What journals have you found to be sympathetic to qualitative health research?

17. The University of Sydney Sydney School of Public Health